MEDICARE: EVA L RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1000732	TX

General Provider Information

NPI Number	:	1083981401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVA L RODRIGUEZ

Provider Business Mailing Address
First Line	:	5504 BANDERA RD
Second Line	:	610
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1943
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5504 BANDERA RD
Second Line	:	610
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1943
Country	:	US
Telephone Number	:	281-397-7557
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EVA L RODRIGUEZ
Credential	:
Telephone Number	:	281-397-7557

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	03/28/2012

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Directions to “EVA L RODRIGUEZ ” Practice Location

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